Recovery from chronic fatigue syndrome: a reflexive thematic analysis of experiences of people before, during and after treatment, 2025, Chalder+

For everyone who can't quite understand what CBT atcually looks like in practice I can highly recommend an interview by Dan of Post-Exertional Mayonnaise on CBT for patients with ME/CFS with Eliza Charley from Australia.

It's a cult like movement that involves brainwashing.

 
Nightsong said:
This is all rather fuzzy - perhaps deliberately so. Because the Chalder formulation does assume that patients have abnormal illness beliefs & behaviours I read it as actually proscribing that model and only allowing CBT formulations based on coming to terms with living with a chronic illness - as is sometimes offered to patients with other serious long-term conditions.
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They're pretty much doing a "foot in the door" thing where CBT is mentioned as an adjunct support treatment for the few who could have some minor benefit from it, then going with the idea that their CBT is based on this fear model, thus their fear model of CBT is recommended, even though the guideline doesn't actually recommend it, it pretty much just says it exists, is available and commonly used. Despite actual evidence of efficacy.

Which is a fundamental problem with the CBT format, it's anything anyone wants it to be, and anyone doing a CBT course will customize it to their liking, so none are ever alike. In systematic reviews everything it contains is compressed down to the single initialism and concept of CBT. It could be CBT that teaches about astrological projection and it would literally make no difference, it would still be CBT because CBT is a process. It could even teach antivaccine conspiracy fantasies and it would still fall in the same category as any of the psychosomatic models. Hell, it could even teach helpful things that are the opposite of Chalder's model and it would still be in the same category in a systematic review.

What's even more absurd is that from the study it doesn't seem that any of the participants even partially recovered on the terms they describe. I didn't bother too much but nothing indicates that. And yet they actually present it as a success, a reader would have to go through a, frankly, unnecessary long and meandering paper to know it. But most will simply read the abstract and quickly scan down, and go with the propaganda they put as a conclusion.

This is propaganda on the same level as what the tobacco industry did.
 
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This paper really does seem essentially to acknowledge that all claims of "recovery" are not, in fact, about "recovery" as commonly understood--absence of symptoms, return to normal life, etc. This is a neat way to get around the problem that the interventions do not seem to lead to "recovery" for most people--just redefine it downward to mean "coping better with chronic illness." So sure, I can see why CBT might prove marginally helpful in that regard.
 
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dave30th said:
This paper really does seem essentially to acknowledge that all claims of "recovery" are not, in fact, about "recovery" as commonly understood--absence of symptoms, return to normal life, etc. This is a neat way to get around the problem that the interventions do not seem to lead to "recovery" for most people--just redefine it downward to mean "coping better with chronic illness." So sure, I can see why CBT might prove marginally helpful in that regard.
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The 'CBT' I had consisted of the 'therapist' announcing "We won't get anywhere all the time you think what's wrong with you is physical!". The first thing she said. I hadn't had a chance to speak. The so called 'CBT' consisted of ham fisted psychotherapy and judgements. I was far too sick to travel to the hospital. She was just downright nasty, a psychiatrist. I tried for 2 sessions then didn't go anymore. She had her revenge. Her write up consisted of a 2 page diatribe of character assassination.

That was 1997, before the clinics. The neurologist who referred me for CBT, and the so called therapist, had clearly been influenced by the 'CBT for CFS' editorials and the research. It definitely was supposed to be CBT because the neurologist's report said that was what he was referring me for (I discovered that years later when I accessed my medical records).

The graded exercise consisted of 10 leg ups per leg (lying flat) and a floor exercise so complicated I couldn't remember it. The physio had the attitude of "Just do it". I didn't. I was far too sick for any of it. They had a horrible attitude.

What I needed was homecare. I was physically collapsing trying to shop for food, with shop staff calling an ambulance as I was virtually unconscious. The friend who had brought in food twice a week had moved to another part of the country at that point. I ended up calling out of a window to a neighbour to ask her if she could pick up some groceries if she was going shopping. Those years were hell on earth. I didn't know anything about ME and veered between being too sick to move or speak or dial the phone, gradually over weeks or months picking up a bit then crashing badly, not able to move or speak, needing an eye mask with sound sensitivity so bad that any kind of rustle was hell.

What I really needed was homecare and a shopping service.
I can't forget those sessions at the hospital (St Helier) though I want to. The neurologist was kindly but oblivious of how sick I was, the psychiatrist and physio were so stupid and horrible. And it was so devastating, because I had thought they would help me.
 
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dave30th said:
This paper really does seem essentially to acknowledge that all claims of "recovery" are not, in fact, about "recovery" as commonly understood--absence of symptoms, return to normal life, etc. This is a neat way to get around the problem that the interventions do not seem to lead to "recovery" for most people--just redefine it downward to mean "coping better with chronic illness." So sure, I can see why CBT might prove marginally helpful in that regard.
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For that, it will definitely be worth citing. It would be great to turn this into an own goal.
 
Alastair Miller's 2025 piece on 'Recovery' on the Sussex ME/CFS Society site has just gone '404 Not Found'.
A glitch? Or timely convenient track covering? The Society keeps a tight rein on the narratives promoted on it's site. And Alastair Miller is now the public media face of the 'ME is a Psycho-Behavioural condition' movement, certainly since NICE 2021 was published.



What's visible on a google search is:

Recovery - Dr Alastair Miller​

Sussex & Kent ME/CFS Society
https://measussex.org.uk › Latest News

30 Jun 2025 — Recovery from illness is an important concept that implies an individual has achieved the same state of health, function and well-being that they enjoyed prior ...Read more




From my 2026 post that link's Miller's Recovery piece, a quote:

Alastair Miller, 2025:

"It is essential that those affected by MECFS are aware that full recovery is possible whatever the severity of the condition notwithstanding the negative messages propagated by some organisations and websites"



measussex.org.uk

Recovery - Dr Alastair Miller - Sussex & Kent ME/CFS Society​

Recovery from illness is an important concept that implies an individual has achieved the same state of health, function and well-being that they enjoyed prior to the illness or event that made them unwell. Both physical and psychological aspects of health are involved. Recovery may be partial...
measussex.org.uk
measussex.org.uk

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Further to my last post on Alastair Miller's 2025 slippery article on 'Recovery' on the Sussex ME/CFS Society site that has gone '404 Not Found'.

Alastair Miller is now the public media face of the 'ME is a Psycho-Behavioural condition' movement, certainly since NICE 2021 was published.

The loss or removal of this article by Alastair Miller deprives ME patients of evidence of the Sussex Society's Medical Advisor's (Alastair Miller) slippery stance and collaboration with the Psycho-Behavioural movement.



Fortunately I have a copy of this article, which can no longer be read on the Sussex ME/CFS Society site, but can be read here on the S4ME Sussex ME/CFS Society Thread -

The article is at the bottom of Page 15 of the Thread.

Lou B Lou

Post in thread 'United Kingdom: Sussex & Kent ME/CFS Society News'

Alastair Miller's 2025 piece on 'Recovery' on the Sussex ME/CFS Society site has just gone '404 Not Found'.

I wonder why? A glitch? Or timely convenient track covering? The Society keeps a tight rein on the narratives promoted on it's site. And Alastair Miller is now the public media face of the 'ME is a Psycho-Behavioural condition' movement, certainly since NICE 2021 was published. The loss or removal of this article by Alastair Miller deprives ME patients of evidence of the Sussex Society's slippery stance and collaboration with the Psycho-Behavioural movement...
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There is a feminist concept in film known as the “Bechdel test” which asks whether a film contains two women who have a conversation with each other, that isn’t about a man.

It useful because critics can say “this film fails the Bechdel test” and generally people understand the film doesn’t have many well-rounded female characters. It also has limitations, but my point is it’s a simple way and recognisable way to evaluate most films.

I don’t want to discuss feminist theory, I just wonder whether there is or should be something like this for research (the Tuller test?) where we can just dismiss a paper like this as unhelpful/junk or those sort of papers which make claims which aren’t proved by the data in the report.

Then when this kind of nonsense comes out people can just say “oh, this paper fails the Tuller test” and everyone knows not to bother with it, unless they want to read garbage (which some do).
 
“Ere Bob, you seen that new paper just published by Chalder? Fails the Tuller test, unsurprisingly”.
 
I would add a 4th concept: the claims made by the authors are not only unsupported by the data reported in their study, and the other studies they cite, they actively contradict it.
 
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